Provider Demographics
NPI:1720416449
Name:BUG TRANSPORTATION LLC
Entity type:Organization
Organization Name:BUG TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-667-9245
Mailing Address - Street 1:PO BOX 31655
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94604-7655
Mailing Address - Country:US
Mailing Address - Phone:510-667-9245
Mailing Address - Fax:510-667-9244
Practice Address - Street 1:1515 AURORA DR
Practice Address - Street 2:SUITE 103A
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3105
Practice Address - Country:US
Practice Address - Phone:510-667-9245
Practice Address - Fax:510-667-9244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)